Acute Crit Care.  2022 Nov;37(4):491-501. 10.4266/acc.2022.01158.

Asynchronies during invasive mechanical ventilation: narrative review and update

• Saavedra SN
• Barisich PVS
• Maldonado JBP
• Lumini RB
• Gómez-González A
• Gallardo A

• KMID: 2540137
• DOI: http://doi.org/10.4266/acc.2022.01158

Abstract

Invasive mechanical ventilation is a frequent therapy in critically ill patients in critical care units. To achieve favorable outcomes, patient and ventilator interaction must be adequate. However, many clinical situations could attempt against this principle and generate a mismatch between these two actors. These asynchronies can lead the patient to worst outcomes; that is why it is vital to recognize and treat these entities as soon as possible. Early detection and recognition of the different asynchronies could favor the reduction of the days of mechanical ventilation, the days of hospital stay, and intensive care and improve clinical results.

Keyword

asynchronies; detection; mechanical ventilation; recognition, treatment strategies

Figure

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  Figure 1. (A) Reverse triggering. (B) Overshooting.

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  Figure 2. Classification of asynchronies according to phrase variables.

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  Figure 3. Different types of ventilation-induced lung injury due to asynchronies.

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  Figure 4. Ultrasound monitoring of the diaphragmatic function. (A) Diaphragmatic excursion. (B) Diaphragmatic thickening fraction.

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